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General NPI Number Information
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NPI Number | 1831298249
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Entity Type | Individual
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Provider Name | YELENA ZHUKLEVICH LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 3380 NOSTRAND AVE STE.1E
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City | BROOKLYN
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State | NY
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Zip | 11229-4056
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Country | US
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Telephone | 917-674-9522
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Fax | 718-764-1165
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Provider Business Mailing Address
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Address Line | 354 VAN SICKLEN STREET 2C
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City | BROOKLYN
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State | NY
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Zip | 11223
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Country | US
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Telephone | 917-674-9522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P0622781
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License Number State | NY
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